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MORPHOLOGICAL CLASSIFICATION and PARAMETERS of SPINE of SCAPULA AMONG SOUTH INDIAN POPULATION Mamatha Y 1, Swaroop N *2, Jagadish 3

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MORPHOLOGICAL CLASSIFICATION and PARAMETERS of SPINE of SCAPULA AMONG SOUTH INDIAN POPULATION Mamatha Y 1, Swaroop N *2, Jagadish 3 International Journal of Anatomy and Research, Int J Anat Res 2019, Vol 7(3.3):6906-10. ISSN 2321-4287 Original Research Article DOI: https://dx.doi.org/10.16965/ijar.2019.253 MORPHOLOGICAL CLASSIFICATION AND PARAMETERS OF SPINE OF SCAPULA AMONG SOUTH INDIAN POPULATION Mamatha Y 1, Swaroop N *2, Jagadish 3. Associate Professor, Department of Anatomy, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India. Assistant Professor, Department of Anatomy, Kodagu Institute of Medical Sciences , Madikeri, Karnataka, India. Statistician, Department of Community Medicine, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India. ABSTRACT Introduction: Scapula is a pivotal bone of Shoulder girdle, critical in stabilizing and permitting various sports movements like swimming, rowing and throwing. Isolated fractures of the scapular spine are rare. Usually, they are associated with other fractures of the shoulder girdle or injuries to the head, lungs, ribs, cervical spine and brachial neurovascular structures constituting 6% of scapular fractures. Objectives: 1) to classify and to obtain the Quantitative morphometric parameters of scapular spine and also to find the asymmetry of the same bilaterally. Methodology: This study was conducted on 100 dried adult Human Scapula. Spine of scapula were observed and classified morphologically, various morphometric measurements like projection length of spine, thickness and height of spine of scapula were taken using digital vernier caliper and thickness measuring gauge micrometer. The data was analysed statistically using SPSS software version 20.0 and were tabulated. Results: The commenest type of spine was fusiform (type I) with 46% and the least was “S” shape type V with 0% incidence. Type II (slender) spine showed least measured values related to all the parameters. Conclusion: Spine of scapula is an important process, provides elegant reinforcement to dorsal surface of scapula. A morphological variation of the same is not a rare entity in our observation. With recent development in surgical approaches towards the clinical conditions of shoulder joint thorough qualitative and quantitative knowledge of the same is necessary for any surgeon which can be an additional aid for the surgeon during surgeries. KEY WORDS: Spine, Scapula, Classification, Fracture, Morphology. Address for Correspondence: Dr Swaroop N, Assistant Professor, Department of Anatomy, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India. Pin Code: 571201 Phone No: 9611886540.E-Mail: [email protected] Access this Article online Journal Information Quick Response code International Journal of Anatomy and Research ICV for 2016 ISSN (E) 2321-4287 | ISSN (P) 2321-8967 90.30 https://www.ijmhr.org/ijar.htm DOI-Prefix: https://dx.doi.org/10.16965/ijar Article Information Received: 15 Jun 2019 Accepted: 05 Aug 2019 Peer Review: 17 Jun 2019 Published (O): 05 Sep 2019 DOI: 10.16965/ijar.2019.253 Revised: None Published (P): 05 Sep 2019 INTRODUCTION 6 % of scapular fractures are scapular spine Scapular bone fractures are rare injuries which fractures. Fractures of scapular body may cause constitutes of 1 % of all the fractures and 5 % of a weak rotator cuff function and loss of an shoulder girdle fractures. Most of the scapular active arm elevation, named ‘pseudo-rupture’ of fractures involve the neck and body, and only the rotator cuff, probably due to inhibition of Int J Anat Res 2019, 7(3.3):6906-10. ISSN 2321-4287 6906 Mamatha Y, et al., MORPHOLOGICAL CLASSIFICATION AND PARAMETERS OF SPINE OF SCAPULA AMONG SOUTH INDIAN POPULATION. the muscle contractions from intramuscular osteologic features. haemorrhage. Also, pseudo-arthrosis of spine of · To evaluate the asymmetry of parameters scapula or acromion, like os acromiale, predis- bilaterally poses to sub-acromial impingement syndrome. METHODOLOGY The pull of the deltoid muscle can tilt the frag- ment inferiorly, which compromises the function The present study was done on one hundred of the rotator cuff. Sagging of the lateral spine (100) dry an adult human scapula. Age and sex projection over acromion effectively produces of the donors were unknown. Types of scapula narrowing of the supraspinatus outlet and were classified into following five types secondary impingement of the rotator cuff [1]. morphologically, Type 1- Fusiform shape (tapered at both ends and wide in the middle), Type 2- As Lambert et al. states in their study, fracture Slender rod shape (thin throughout), Type 3- of scapular spine represents a partial failure of Thick rod shape (thick throughout), Type 4- the lateral scapular suspension system, Wooden club shape(gradual thickening from leading for failure of scapular postural control, medial to lateral edge), Type 5- Horizontal with resulting sub-acromial impingement result- S-shape (“S” shaped spine) . Nine bony land- ant impingement syndromes of the shoulder. marks described for their relevance to regions Although scapular spine fractures are rarely of interest for scapular fixation were chosen and seen, they must be considered in differential marked (Fig 1, 2).Measurements were taking diagnosis of impingement syndromes of the using digital vernier caliper and thickness of shoulder [2]. spine was taken using thickness measuring How the trabecular bone density varies within guage digital micrometer. the scapula and how can this may lead to more • AE (superior border of SS): length of SS mea- optimal Reverse Shoulder Arthroplasty (RSA) sured from the medial edge of the scapula where screw placement has not been addressed in the it meets with the SS to the lateral midpoint of scientific literature. The three columns of tra- lateral edge of the acromion. becular bone runs within the scapula adjacent to the glenoid fossa, one extending through the • AD: length of SS measured from the medial base of the coracoid process, a second along edge of the scapula where it meets with the SS the lateral border, and a third extending into the to the corner of the acromion. spine of scapula, were hypothesized to be of • AC (base border of SS): distance from the similar density relatively. The base of the cora- medial edge of the scapula where it meets with coid process was statistically significantly less the SS to the edge of the spinoglenoid notch. dense than the spine and the lateral border of • BC (lateral border of SS): height of the spine the scapulae examined (P < 0.5). The higher- at the lateral edge. quality bone component in the lateral border • FG and HI: Height of the spine at point G and I. and spine, compared with the coracoid region, • J, K, L: midpoints of FG, HI, and BC. may provide better bone plate for screws when fixing the glenoid baseplate in RSA. AS the stud- ies done related to morphological and morpho- metric parameters of spine of Scapula is quite rare though the variations is quite common, the present study was done to add into the data of spine of scapula which may be helpful for orthopedicians [3]. Objectives: Fig. 1: Fig. 2: · The objective of this study was to classify the Statistical data: All data observed are presented SS (scapular spine) morphologically as Mean and standard deviation (SD). Descrip- · To provide baseline data of specific geometri- tive statistics was used to describe demograph- cal parameters of scapular spine according to ics and measurement variables of all scapulae. Int J Anat Res 2019, 7(3.3):6906-10. ISSN 2321-4287 6907 Mamatha Y, et al., MORPHOLOGICAL CLASSIFICATION AND PARAMETERS OF SPINE OF SCAPULA AMONG SOUTH INDIAN POPULATION. Categorical variables are expressed as frequen- Fig. 3: Showing different types of Spine of Scapula. cies and percentages. Unpaired “t” test was used to compare types considering a P-value < 0.05 as statistically significant. The Statistical Pack- age for Social Sciences (SPSS version 20.0) was used for the analysis of the data. RESULTS In the present study, the commonest type of spine was fusiform (type I) with 38%, second Type I: fusiform Type II: slender being the type IV with 28% followed by type III with 24%, Type II with 10% and the least was “S” shape type V with 0% incidence, not much of the difference observed bilaterally (Table 1). Table 1: Showing percentage of morphological different types of spine of Scapula. TYPE Out of 100 Based on side N (%) Right(50) 19(38) I 35 Left(50) 16(32) Type III: thick rod shape Type IV: Wooden club shape Right(50) 05(10) II 16 32.8±6.7mm respectively.. A complete descrip- Left(50) 11(22) tion and summary of the results can be observed Right(50) 12(24) III 21 in Table 2. No significant difference was found Left(50) 09(18) between left and right scapulae. A summary of Right(50) 14(28) IV 28 the thickness for the bony landmarks on the SS Left(50) 14(28 is shown in (table 3). “L’’ representing thick- V NIL NIL NIL ness at midpoint of BC being the thickest in all The average length of AE, AD, AC and BC on types , Type II was the thinnest and shed least right and left side were 140.6 ± 10.1 to 115.7± values. Overall, Type 1, 3, 4 showed thicker val- 3.3 mm, 124.4 ±7.5 to 107.7± 4.14, 88.6± 7.0 to ues . No statistical difference was found between 69.66 ± 4.8mmand 44.1± 4.5 to 32.8± 6.7mm , left and right sides of the body. p value>0.05 127.9±7.4 to 123.0± 9.8mm, 120.5±7.5 to 114.7± was not statistically significant. 10.7mm, 82.9±11.6 to 78.9±7.4mm , 38.0±6.9 to Table 2: Distribution and Measurements of the Scapular Spine based on Sides among different types of scapula. AE AD AC BC FG HI TYPES SIDE N (%) Mean±SD Mean±SD Mean±SD
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